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1.
BMC Med Educ ; 21(1): 368, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225725

RESUMO

BACKGROUND: Appropriate training of health professionals has been recommended to increase organ donation rates. Some studies have shown insufficient knowledge among medical students. This survey aims to describe their knowledge and attitude toward organ donation (OD). METHOD: We designed, pre-tested and conducted an online survey of all undergraduate medical students from Montreal, Laval and Sherbrooke universities in 2016-2017. Multivariate linear regression identified factors associated with a better knowledge score. RESULTS: Twenty-two percent (750/3344) of students completed the survey. Ninety-one percent of students adequately knew that neurological death is irreversible; 76% acknowledged that someone could be neurologically deceased while his heart is still beating; 69% were not aware of circulatory determination of death. For only one knowledge item, senior students had a better answer than junior students. Total knowledge score was associated with exposure to OD during medical studies and comfort in answering patients' questions about OD (p < 0,001). Regarding attitude, 96% of respondents wished to become organ donors after death and 92% supported OD training during their medical training. CONCLUSION: Despite a favourable attitude, medical students have limited knowledge of OD. Findings suggest the need for a formal curriculum about OD, as students expressed.


Assuntos
Estudantes de Medicina , Obtenção de Tecidos e Órgãos , Canadá , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Inquéritos e Questionários
2.
Nurs Leadersh (Tor Ont) ; 34(2): 1-4, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34197285

RESUMO

It is time to acknowledge what has been hidden inside Canada's healthcare system for decades but has become more visible during the COVID-19 pandemic: widespread stress, mental health problems and burnout in the nursing workforce. For the past 20+ years, repeated concerns about the mental health of nurses in Canada have been raised within many national reports, yet the rates have continued to rise.


Assuntos
Liderança , Enfermeiras e Enfermeiros/psicologia , COVID-19/epidemiologia , Canadá/epidemiologia , Atenção à Saúde/organização & administração , Humanos , Pandemias , SARS-CoV-2
3.
Nurs Leadersh (Tor Ont) ; 34(2): 45-53, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34197294

RESUMO

Absenteeism rates among nurses have increased across Canada over the last several years, with work environment challenges and staffing shortages being possible contributors. With the onset of the COVID-19 pandemic, nurses have worked under increasingly stressful conditions. Unsurprisingly, many nurses are facing mental health challenges. Digital tools to support and enhance access to mental health services are one strategy to support the mental health of nurses. This paper outlines the digital tools and virtual programs available to support the mental health of nurses, recognizing that there is no single solution to address the mental health challenges faced by Canadian nurses during these difficult times.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Grupos de Autoajuda , Rede Social , COVID-19/epidemiologia , COVID-19/enfermagem , Canadá , Humanos , Serviços de Saúde Mental/organização & administração , Aplicativos Móveis , Pandemias , SARS-CoV-2 , Tecnologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-34204907

RESUMO

BACKGROUND: COVID-19 preventive measures have been an obstacle to millions of people around the world, influencing not only their normal day-to-day activities but also affecting their mental health. Social distancing is one such preventive measure. People express their opinions freely through social media platforms like Twitter, which can be shared among other users. The articulated texts from Twitter can be analyzed to find the sentiments of the public concerning social distancing. OBJECTIVE: To understand and analyze public sentiments towards social distancing as articulated in Twitter textual data. METHODS: Twitter data specific to Canada and texts comprising social distancing keywords were extrapolated, followed by utilizing the SentiStrength tool to extricate sentiment polarity of tweet texts. Thereafter, the support vector machine (SVM) algorithm was employed for sentiment classification. Evaluation of performance was measured with a confusion matrix, precision, recall, and F1 measure. RESULTS: This study resulted in the extraction of a total of 629 tweet texts, of which, 40% of tweets exhibited neutral sentiments, followed by 35% of tweets showed negative sentiments and only 25% of tweets expressed positive sentiments towards social distancing. The SVM algorithm was applied by dissecting the dataset into 80% training and 20% testing data. Performance evaluation resulted in an accuracy of 71%. Upon using tweet texts with only positive and negative sentiment polarity, the accuracy increased to 81%. It was observed that reducing test data by 10% increased the accuracy to 87%. CONCLUSION: Results showed that an increase in training data increased the performance of the algorithm.


Assuntos
COVID-19 , Mídias Sociais , Canadá , Humanos , Distanciamento Físico , SARS-CoV-2
5.
Front Public Health ; 9: 671833, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34222176

RESUMO

The magnitude of the COVID-19 pandemic challenged societies around our globalized world. To contain the spread of the virus, unprecedented and drastic measures and policies were put in place by governments to manage an exceptional health care situation while maintaining other essential services. The responses of many governments showed a lack of preparedness to face this systemic and global health crisis. Drawing on field observations and available data on the first wave of the pandemic (mid-March to mid-May 2020) in Quebec (Canada), this article reviewed and discussed the successes and failures that characterized the management of COVID-19 in this province. Using the framework of Palagyi et al. on system preparedness toward emerging infectious diseases, we described and analyzed in a chronologically and narratively way: (1) how surveillance was structured; (2) how workforce issues were managed; (3) what infrastructures and medical supplies were made available; (4) what communication mechanisms were put in place; (5) what form of governance emerged; and (6) whether trust was established and maintained throughout the crisis. Our findings and observations stress that resilience and ability to adequately respond to a systemic and global crisis depend upon preexisting system-level characteristics and capacities at both the provincial and federal governance levels. By providing recommendations for policy and practice from a learning health system perspective, this paper contributes to the groundwork required for interdisciplinary research and genuine policy discussions to help health systems better prepare for future pandemics.


Assuntos
COVID-19 , Pandemias , Canadá , Humanos , Pandemias/prevenção & controle , Quebeque/epidemiologia , SARS-CoV-2
6.
BMJ Open ; 11(7): e050714, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210736

RESUMO

OBJECTIVES: The primary objective was to estimate the positivity rate of air travellers coming to Toronto, Canada in September and October 2020, on arrival and on day 7 and day 14. The secondary objectives were to estimate the degree of risk based on country of origin and to assess knowledge and attitudes towards COVID-19 control measures and subjective well-being during the quarantine period. DESIGN: Prospective cohort of arriving international travellers. SETTING: Toronto Pearson Airport Terminal 1, Toronto, Canada. PARTICIPANTS: Participants of this study were passengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport, spoke English or French, and provided consent. Excluded were those taking a connecting flight, had no internet access, exhibited symptoms of COVID-19 on arrival or were exempted from quarantine. MAIN OUTCOME MEASURES: Positive for SARS-CoV-2 virus on reverse transcription PCR with self-administered oral-nasal swab and general well-being using the WHO-5 Well-being Index. RESULTS: Of 16 361 passengers enrolled, 248 (1.5%, 95% CI 1.3% to 1.7%) tested positive. Of these, 167 (67%) were identified on arrival, 67 (27%) on day 7, and 14 (6%) on day 14. The positivity rate increased from 1% in September to 2% in October. Average well-being score declined from 19.8 (out of a maximum of 25) to 15.5 between arrival and day 7 (p<0.001). CONCLUSIONS: A single arrival test will pick up two-thirds of individuals who will become positive by day 14, with most of the rest detected on the second test on day 7. These results support strategies identified through mathematical models that a reduced quarantine combined with testing can be as effective as a 14-day quarantine.


Assuntos
COVID-19 , Aeroportos , Canadá , Estudos de Coortes , Humanos , Estudos Prospectivos , SARS-CoV-2
7.
BMJ Open ; 11(7): e051278, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215614

RESUMO

INTRODUCTION: Cough is a common symptom of COVID-19 and other respiratory illnesses. However, objectively measuring its frequency and evolution is hindered by the lack of reliable and scalable monitoring systems. This can be overcome by newly developed artificial intelligence models that exploit the portability of smartphones. In the context of the ongoing COVID-19 pandemic, cough detection for respiratory disease syndromic surveillance represents a simple means for early outbreak detection and disease surveillance. In this protocol, we evaluate the ability of population-based digital cough surveillance to predict the incidence of respiratory diseases at population level in Navarra, Spain, while assessing individual determinants of uptake of these platforms. METHODS AND ANALYSIS: Participants in the Cendea de Cizur, Zizur Mayor or attending the local University of Navarra (Pamplona) will be invited to monitor their night-time cough using the smartphone app Hyfe Cough Tracker. Detected coughs will be aggregated in time and space. Incidence of COVID-19 and other diagnosed respiratory diseases within the participants cohort, and the study area and population will be collected from local health facilities and used to carry out an autoregressive moving average analysis on those independent time series. In a mixed-methods design, we will explore barriers and facilitators of continuous digital cough monitoring by evaluating participation patterns and sociodemographic characteristics. Participants will fill an acceptability questionnaire and a subgroup will participate in focus group discussions. ETHICS AND DISSEMINATION: Ethics approval was obtained from the ethics committee of the Centre Hospitalier de l'Université de Montréal, Canada and the Medical Research Ethics Committee of Navarre, Spain. Preliminary findings will be shared with civil and health authorities and reported to individual participants. Results will be submitted for publication in peer-reviewed scientific journals and international conferences. TRIAL REGISTRATION NUMBER: NCT04762693.


Assuntos
COVID-19 , Pandemias , Acústica , Inteligência Artificial , Canadá , Surtos de Doenças , Humanos , Estudos Observacionais como Assunto , SARS-CoV-2 , Espanha/epidemiologia
8.
J Med Syst ; 45(8): 78, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34231049

RESUMO

Surgical trays contain unused instruments which generate wasted resources from unnecessary reprocessing/replacement costs. We implemented a quality improvement initiative to optimize surgical trays for common otolaryngology procedures, and examined the impact on costs, operating room (OR) efficiency, and patient safety.We studied five common otolaryngology procedures over a 10-month period at a single community hospital. We compared pre- and post-intervention outcome measures including instrument utilization, tray set up time, tray rebuilding time, and balancing measures (operative time, instrument recall, patient safety). We estimated cost-savings from an institutional perspective over 1- and 10-year time horizons. Costs were expressed in 2017 Canadian dollars and modeled as a function of surgical volume, labor costs, instrument depreciation, and indirect costs.A total of 238 procedures by six surgeons were observed. At baseline, only 35% of instruments were utilized. We achieved an average instrument reduction of 26%, yielding 1-year cost savings of $9,010 CDN and 10-year cost savings of $69,576 CDN. Tray optimization reduced average OR tray setup time by 2.5 ± 0.4 min (p = 0.03) and average tray rebuilding time by 1.4 ± 0.2 min (p = 0.06). There was minimal impact on balancing measures such as OR time, stakeholder perception of patient safety and trainee education, and only a single case of instrument recall.Surgical tray optimization is a simple, effective, and scalable strategy for reducing costs and improving OR efficiency without compromising patient safety.


Assuntos
Salas Cirúrgicas , Instrumentos Cirúrgicos , Canadá , Redução de Custos , Humanos , Melhoria de Qualidade
9.
Int J Pediatr Otorhinolaryngol ; 147: 110803, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34198156

RESUMO

BACKGROUND: Diagnostic polysomnography (PSG) is recommended prior to adenotonsillectomy (AT) for children with obstructive sleep apnea (OSA) and certain high-risk characteristics, but resource limitations often prevent this practice. OBJECTIVE: We performed a population-based assessment of children across Ontario, Canada to describe and quantify disparities in PSG. METHODS AND MATERIALS: This retrospective cohort study was performed using provincial health administrative data held at ICES. We identified children 0-10 years old who underwent PSG and AT between 2009 and 2018, and those with a PSG within 18 months prior to and/or 12 months following AT. We calculated the odds of PSG prior to/following AT after adjustment for demographics, medical comorbidities, geographic and socioeconomic characteristics. Our main predictor was driving time/distance to the nearest pediatric sleep centre ascertained using spatial analysis and geographic information systems. RESULTS: We identified 27,837 children <10 years old who underwent AT for OSA in Ontario. Only 12.8% had a PSG within 18 months prior and 5.7% had a PSG within 12 months following AT. Shorter driving time/distance, older age, male sex and certain comorbidities were associated with increased odds of PSG. CONCLUSION: Only a small proportion of children in our cohort underwent PSG prior to or following AT surgery despite universal access to healthcare. This study suggests a need to increase overall PSG access, particularly for those living distant from existing pediatric sleep centres. Future studies could determine if increased PSG testing in 'underserviced areas' would reduce overall surgery rates and/or improve health outcomes.


Assuntos
Apneia Obstrutiva do Sono , Idoso , Canadá , Criança , Pré-Escolar , Acesso aos Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Polissonografia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34199448

RESUMO

BACKGROUND: Women after breast cancer (BC) cope with decreased daily participation and quality of life (QOL) due to physical, cognitive, and emotional symptoms. This study examined a hybrid occupation-based intervention, Managing Participation with Breast Cancer (MaP-BC), to improve daily participation in their meaningful activities. METHODS: Thirty-five women after BC phase were randomly allocated to the MaP-BC intervention (n = 18) or control (n = 17) group (standard care only). Assessments were administered at baseline (T1), 6-week (T2), and 12-week (T3) post-T1. MAIN OUTCOME: perceived performance and performance-satisfaction with meaningful activities according to the Canadian Occupational Performance Measure. SECONDARY OUTCOMES: retained activity levels (Activity Card Sort), QOL (Functional Assessment of Cancer Therapy-Breast), cognitive abilities (Montreal Cognitive Assessment and Behavior Rating Inventory of Executive Function), and upper-extremity functioning (Disability of Arm, Shoulder, Hand). Results showed significant interaction (group x time) effects for the primary outcome in performance, F(2,66) = 29.54, p = 0.001, ɳP2 = 0.472, and satisfaction, F(2,66) = 37.15, p = 0.000, ɳP2 = 0.530. The intervention group improved more in performance, t = 5.51, p = 0.0001, d = 1.298, and satisfaction, t = -5.32, p = 0.0001, d = 1.254, than the control group between T1 and T2. Secondary outcomes demonstrated within-group improvements. CONCLUSION: MaP-BC, a comprehensive occupation-based hybrid intervention tailored to women's functional daily needs after BC, improved participation in meaningful activities within a short period.


Assuntos
Neoplasias da Mama , Qualidade de Vida , Atividades Cotidianas , Neoplasias da Mama/terapia , Canadá , Feminino , Humanos , Ocupações , Projetos Piloto
11.
J Emerg Manag ; 19(3): 253-265, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34195979

RESUMO

Providing care in a twenty-first century urban emergency department (ED) and trauma center is a complex high-pressure practice environment. The pressure is intensified during patient surge scenarios commonly seen during mass casualty incidents, such that response must be practiced regularly. Beyond clinical mastery of individual patient trauma care, a coordinated system-level response is essential to optimize patient care during these relatively infrequent events. This paper highlights the need to perform exercises in hospitals while providing practical advice on how to utilize in situ simulation for mass casualty testing. Eleven lessons are presented to assist other emergency management professionals, hospital administrators, or clinical staff to achieve success with in situ simulation. Based upon our experience designing and executing an in situ mass casualty simulation within an ED, we offer lessons applicable to any type of disaster exercise. Simulation offers a powerful tool for the conduct of disaster preparedness exercises for staff across multiple hospital departments and professions.


Assuntos
Planejamento em Desastres , Incidentes com Feridos em Massa , Canadá , Serviço Hospitalar de Emergência , Hospitais , Humanos , Triagem
13.
BMJ Case Rep ; 14(7)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210695

RESUMO

A 67-year-old woman presented with painful, acute vision loss after 5 days of fever and muscle aches while visiting the Dominican Republic. She had no recent history of ocular surgery, dental work or recent trauma. Anterior chamber aspiration confirmed an initial diagnosis of endogenous endophthalmitis, positive for Streptococcus mitis that progressed to panophthalmitis on return to Canada. Treatment included systemic antibiotics, intravitreal antibiotics and intravitreal dexamethasone. Despite the best medical treatment, the left eye progressed to corneal perforation 5 weeks after presentation. An evisceration with fitted orbital implant was successful in alleviating pain following the surgery. S. mitis is a rare, but possible cause of endogenous endophthalmitis and panophthalmitis. It was important to work with a multidisciplinary and global team to coordinate and offer appropriate treatment measures. Although vision was lost, evisceration of the left eye provided ocular comfort and good cosmetic outcomes for the patient.


Assuntos
Endoftalmite , Panoftalmite , Idoso , Canadá , República Dominicana , Endoftalmite/tratamento farmacológico , Feminino , Humanos , Estudos Retrospectivos , Streptococcus mitis
14.
Artigo em Inglês | MEDLINE | ID: mdl-34281049

RESUMO

BACKGROUND: The perinatal period is a particularly vulnerable period in women's lives that implies significant physiological and psychological changes that can place women at higher risk for depression and anxiety symptoms. In addition, the ongoing pandemic of coronavirus disease 2019 (COVID-19) is likely to increase this vulnerability and the prevalence of mental health problems. This review aimed to investigate the existing literature on the psychological impact of the COVID-19 pandemic on women during pregnancy and the first year postpartum. METHOD: The literature search was conducted using the following databases: Pubmed, Scopus, WOS-web of science, PsycInfo and Google Scholar. Out of the total of 116 initially selected papers, 17 have been included in the final work, according to the inclusion criteria. RESULTS: The reviewed contributions report a moderate to severe impact of the COVID-19 outbreak on the mental health of pregnant women, mainly in the form of a significant increase in depression-up to 58% in Spain-and anxiety symptoms-up to 72% in Canada. In addition to the common psychological symptoms, COVID-19-specific worries emerged with respect to its potential effects on pregnancy and the well-being of the unborn child. Social support and being engaged in regular physical activities appear to be protective factors able to buffer against the effects of the pandemic on maternal mental health. CONCLUSIONS: Despite the limitations of the study design, the evidence suggests that it is essential to provide appropriate psychological support to pregnant women during the emergency in order to protect their mental health and to minimize the risks of long-term effects on child development.


Assuntos
COVID-19 , Pandemias , Ansiedade , Canadá , Criança , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental , Parto , Gravidez , SARS-CoV-2 , Espanha , Estresse Psicológico
15.
Artigo em Inglês | MEDLINE | ID: mdl-34281075

RESUMO

Canada is a federal state of almost 38 million inhabitants distributed over ten provinces and three territories, each with their own power regarding health. This case study describes the health infrastructures' situation before the COVID-19 outbreak and their adaptations to face the expected cases, the available epidemiologic data for the beginning of the first wave (January-April 2020), and the public health and economic measures taken to control the pandemic both at the federal level and breaking down by province and territory. Canadian health infrastructures offered on average 12.9 intensive care units beds per 100,000 (occupancy rate ~90% before the outbreak), unevenly distributed across provinces and territories. Canada implemented public health measures, such as social distancing, when hospitalization and death rates due to the pandemic were still lower than in other countries; each province and territory adapted and implemented specific measures. Cumulated cases and deaths substantially increased from mid-March 2020, reaching 65 cases and 2 deaths per 100,000 on April 12, with strong differences across provinces and territories. Canada has been affected by the COVID-19 pandemic's first wave with a generally slower dynamic than in the USA or in the European Union at the same period. This suggests that implementation of public health measures when health indicators were still low may have been efficient in Canada; yet the long-term care sector faced many challenges in some provinces, which drove a large part of the pandemic indicators.


Assuntos
COVID-19 , Pandemias , Canadá/epidemiologia , Humanos , Unidades de Terapia Intensiva , SARS-CoV-2
16.
Br J Nurs ; 30(14): S34-S41, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34288748

RESUMO

PURPOSE: For the student nurse, peripheral venous cannulation is one of the most stressful skills to be learned. Although some healthcare employers/establishments offer courses on vascular access and infusion nursing as part of their onboarding programs, ultimately educational institutions should share the responsibility to ensure that graduating nurses can provide safe infusion therapies. METHODS: An innovative vascular access and infusion nursing (VAIN) curriculum was created and mapped onto the entry to practice undergraduate nursing program at McGill University in Montréal, Québec, Canada. This presented an opportunity to implement new teaching approaches. RESULTS: Students experienced multiple new teaching approaches including multimedia and experiential learning and live simulation to ensure acquisition of knowledge and psychomotor skills. The teaching approaches had to be rapidly modified with the advent of the COVID-19 pandemic. CONCLUSIONS: The VAIN curriculum emphasizes simulation and directed practice, seeking to increase competence, confidence, and knowledge. The pandemic underscored the need for flexibility and creativity in content delivery.


Assuntos
COVID-19 , Cateterismo Periférico , Bacharelado em Enfermagem , Estudantes de Enfermagem , Canadá/epidemiologia , Cateterismo Periférico/enfermagem , Currículo , Difusão de Inovações , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/organização & administração , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Estudantes de Enfermagem/psicologia , Ensino
17.
Chemosphere ; 281: 130921, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34289608

RESUMO

Passive biological treatment using constructed wetlands has been employed as a cost-effective and environmentally friendly alternative for mine effluents treatment in Canada. The current work aimed to assess the performance of a laboratory-scale constructed wetland for the removal of selenium, nutrients and heavy metals. This work achieved a maximum selenium removal rate of 54.13% corresponding to the highest hydraulic residence time (almost 47 days). Typha Latifolia was efficient for selenium assimilation and removal from mine effluent. 4.4% of Se mass was accumulated in the under and aboveground biomass while 32.2% was volatilized. Levels <1.69 mg of selenate, <1.69 mg of selenite, <3.39 mg of selenomethionine and <3.39 mg of unknown selenium species were distributed in the underground biomass while levels <0.75 mg of selenate, <0.75 mg of selenite, <1.51 mg of selenomethionine and <1.51 mg of unknown selenium species were found in T. Latifolia leaves. Ammonia removal was mainly based on a nitrification process confirmed by the decrease of ammonia (>96%) and nitrite in association with the increase of nitrate concentrations in the outlet compared to the inlet. The concentrations of other nitrogen compounds mainly thiocyanate and cyanate have significantly decreased from initial average values of 163 and 22.7 mg.L-1 in the influent to 1.5 and 0.3 mg.L-1 final concentrations, respectively. Orthophosphate concentrations were also efficiently decreased from an influent average value of 21.5 ± 3.3 mg.L-1 to an effluent concentration of 9.1 ± 4.4 mg.L-1. Understanding the selenium and nutrient removal mechanisms will allow treatment performance enhancement and the development of large-scale constructed wetlands for sophisticated mine effluent treatment.


Assuntos
Metais Pesados , Selênio , Canadá , Nutrientes , Áreas Alagadas
18.
Chemosphere ; 281: 130948, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34289615

RESUMO

To investigate the bioaccumulation behavior of dodecamethylcyclohexasiloxane (D6, CAS number: 540-97-6) in fish, an OECD-305 style dietary bioaccumulation study of D6 in rainbow trout was conducted in the presence of non-metabolizable reference chemicals. The dietary uptake absorption efficiency of D6 was 14 (3 SE) % and lower than that of the reference chemicals which ranged between 22 (2 SE) to 60 (8 SE) %. The concentration of D6 in the body of the fish showed a rapid 40% drop during the first day of the depuration phase, followed by a slower decline during the remainder of the depuration period. The overall depuration rate constant of D6 was 0.016 (0.0026 SE) d-1 and significantly greater than those of PCB153 and PCB209, which were not significantly different from zero. During the depuration phase, when fish body weight did not significantly change over time, depuration of D6 appears to be almost entirely due to biotransformation in the body of the fish. The biomagnification factor of D6 in rainbow trout was 0.38 (0.14 SE) kg-lipid kg-lipid-1, indicating a lack of biomagnification. The bioconcentration factor (BCF) of D6 in Rainbow trout was estimated at 1909 (483 SE) L kg-1 wet for natural waters of mostly oligotrophic lakes in Northern Canada with an average concentration of total organic carbon of 7.1 mg L-1. Comparing the bioaccumulation profile of D6 to that of 238 similar profiles for 166 unique chemicals indicates that the bioaccumulation capacity of D6 is markedly less than that of many very hydrophobic organochlorines.


Assuntos
Oncorhynchus mykiss , Poluentes Químicos da Água , Animais , Bioacumulação , Canadá , Oncorhynchus mykiss/metabolismo , Siloxanas , Poluentes Químicos da Água/análise
19.
Med Educ Online ; 26(1): 1950108, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34232843

RESUMO

BACKGROUND: Few studies have been published about specialty-specific fourth-year medical student leadership in any discipline. This paper provides insight from pediatric educators about the current status and recommendations for pediatric-specific fourth-year leaders. OBJECTIVE: To identify the prevalence of pediatric fourth-year medical student directors across the US and Canada and to compare current and ideal responsibilities for this role. METHODS: Five multi-part questions were written and submitted for the 2019 Council on Medical Student Education in Pediatrics (COMSEP) Annual Survey and subsequently disseminated to all COMSEP member physicians. Anonymous responses were collected and results analyzed. The study was IRB exempt. RESULTS: The program-level survey response rate was 79%. Of 115 respondent medical schools, 37% reported having a pediatric fourth-year director separate from the clerkship director, with an average of 9.8% full-time equivalent (FTE) protected time for the role. In contrast, individuals indicated 20% FTE would be ideal for fourth-year director responsibilities. The most common role identified for pediatric fourth-year directors was directing sub-internships. Respondents indicated it would be ideal for pediatric fourth-year directors to have an increased level of involvement in all areas queried in the survey, especially directing a pediatric residency preparatory course/boot camp, faculty development for educators of fourth-year students, and remediating fourth-year students. CONCLUSIONS: As specialty-specific experiences have grown in the fourth year of medical school, there is an increasing demand for faculty leadership separate from direction of the pediatric clerkship. In this national survey, pediatric educators expressed a need for additional protected time to lead fourth-year specific activities. Similar findings in other disciplines would support advocating for more protected time and expanded roles for specialty-specific fourth-year directors nationally.


Assuntos
Estágio Clínico/organização & administração , Liderança , Pediatria/educação , Faculdades de Medicina/organização & administração , Estudantes de Medicina , Canadá , Criança , Humanos , Internato e Residência/organização & administração , Masculino , Papel do Médico , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-34202309

RESUMO

Objective: Countermeasures introduced during the COVID-19 pandemic produced an environment that placed some children at increased risk of maltreatment at the same time as there were decreased opportunities for identifying and reporting abuse. Unfortunately, coordinated government responses to address child protection since the start of the pandemic have been limited in Canada. As an exploratory study to examine the potential academic evidence base and location of expertise that could have been used to inform COVID-19 pandemic response, we undertook a review of child maltreatment research across three prominent Canadian professional journals in social work, medicine and public health. Methods: We conducted a pre-pandemic, thirteen-year (2006-2019) archival analysis of all articles published in the Canadian Social Work Review (CSWR), the Canadian Medical Association Journal (CMAJ) and the Canadian Journal of Public Health (CJPH) and identified the research articles that related directly to child maltreatment, child protection or the child welfare system in Canada. Results: Of 11,824 articles published across the three journals, 20 research papers relating to child maltreatment, child protection or the child welfare system were identified (CJPH = 7; CMAJ = 3; CSWR = 10). There was no obvious pattern in article topics by discipline. Discussion: Taking these three prominent professional journals as a portal into research in these disciplines, we highlight the potential low volume of academic child maltreatment research despite the importance of the topic and irrespective of discipline. We believe that urgent transdisciplinary collaboration and overall awareness raising for child protection is called for at the time of the COVID-19 pandemic as well as beyond in Canada.


Assuntos
COVID-19 , Maus-Tratos Infantis , Canadá/epidemiologia , Criança , Proteção da Criança , Humanos , Pandemias , Saúde Pública , SARS-CoV-2
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